改良弧形扩大跗骨窦入路治疗跟骨骨折临床研究  

Clinical Study of Modified Arc Extended Tarsal Sinus Approach on the Treatment of Patients with Calcaneal Fractures

作　　者：董延旭[1] 金立昆[1] 金桥 张杰[1] 孙新 侯云杰 戴禹润 李晔[1] DONG Yanxu;JIN Likun;JIN Qiao;ZHANG Jie;SUN Xin;HOU Yunjie;DAI Yurun;LI Ye(Beijing Fengsheng Traditional Chinese Medicine Orthopedic Hospital,Beijing 100039,China;Beijing Xuanwu Traditional Chinese Medicine Hospital,Beijing 100050,China)

机构地区：[1]北京市丰盛中医骨伤专科医院,北京100039 [2]北京市宣武中医院

出　　处：《中国中医骨伤科杂志》2024年第4期49-54,共6页Chinese Journal of Traditional Medical Traumatology & Orthopedics

基　　金：北京市西城区财政科技专项(XCSTS-TI2022-35)。

摘　　要：目的:观察改良弧形扩大跗骨窦入路治疗SandersⅡ、Ⅲ型跟骨骨折的临床疗效及安全性。方法:选取2021年6月至2023年1月收治的SandersⅡ、Ⅲ型跟骨骨折患者的临床资料共56例,按手术方式分为改良弧形扩大跗骨窦入路组(28例)和跗骨窦入路组(28例)。所有患者术前、术后定期摄片,比较两组患者受伤至手术时间间隔、手术时间、切口长度、出血量、跟骨长度、宽度、高度、Bohler角、Gissane角、跟骨内翻角、切口愈合时间、骨折愈合时间、美国足踝外科协会(AOFAS)踝-后足评分量表评分。记录两种手术方式术后并发症。结果:两组患者均顺利完成手术,无严重神经、血管损伤并发症。改良弧形扩大跗骨窦入路组术中的手术时间、出血量均显著优于跗骨窦入路组,差异有统计学意义(P<0.05)。改良弧形扩大跗骨窦入路组的切口长度显著长于跗骨窦入路组,差异有统计学意义(P<0.05)。两组患者受伤至手术时间间隔、跟骨长度、宽度、高度、Bohler角、Gissane角、跟骨内翻角、切口愈合时间、骨折愈合时间、踝-后足评分量表评分差异无统计学意义(P>0.05)。结论:改良弧形扩大跗骨窦入路治疗SandersⅡ、Ⅲ型跟骨骨折切口愈合好,手术时间缩短,出血量减少,临床治疗效果满意。Objective:To investigate the curative efficacy and safety of modified arc extended tarsal sinus approach on the treatment of patients with Sanders Ⅱ,Ⅲ calcaneal fractures.Methods:56 patients with Sanders Ⅱ,Ⅲ calcaneal fractures were chosen as the research object from June 2021 to January 2023.They were randomly divided into modified arc extended tarsal sinus approach group(28 patients)and tarsal sinus approach group(28 patients)according to random number table.All patients were radiographed regularly before and after surgery.The time waiting for surgery,operative time,incision length,intraoperative blood loss,calcaneal length,width,height,Bolher angle,Gissane angle,calcaneus varus angle,incision healing time,fracture healing time and American orthopaedic foot and ankle society(AOFAS)scores were observed and compared between the two groups.Postoperative complications were recorded.Results:Both groups successfully completed the operation without serious neurological and vascular injury complications.The operative time,intraoperative blood loss in the modified arc extended tarsal sinus approach group were less than those in the tarsal sinus approach group(P<0.05).The incision length in the modified arc extended tarsal sinus approach group were longer than those in the tarsal sinus approach group(P<0.05).There was no statistically significant difference in the time waiting for surgery,calcaneal length,width,height,Bolher angle,Gissane angle,calcaneus varus angle,incision healing time,fracture healing time and AOFAS scores in both group(P>0.05).Conclusion:Compared with the tarsal sinus approach,modified arc extended tarsal sinus approach make fracture incision healed well,reduce the operation time and intraoperative blood loss.The curative efficacy was satisfactory.

关 键 词：跟骨骨折 改良跗骨窦入路 微创内固定术 

分 类 号：R683.42[医药卫生—骨科学]